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CP2 - DERMATOLGY > The Skin and Systemic Disease > Flashcards

The Skin and Systemic Disease Flashcards

1
Q

What systemic condition would you see Necrobiosis lipodica in?

A

Diabetes

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2
Q

Appearance of Necrobiosis lipodica

A

Circumscribed, multicoloured, waxy, atrophic plaques

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3
Q

How many lesions tend to be present in Necrobiosis lipodica

A

1-3

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4
Q

What might there be a history of with necrobiosis lipodica

A

Trauma

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5
Q

Where on the body does necrobiosis lipodica tend to be found?

A

Bony areas; espec shins/dorsum of foot

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6
Q

Who tends to get necrobiosis lipodica?

A

Young adults (F)

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7
Q

4 other dermatlogical conditions associated with DM

A

Candidal paronychia
Furunculosis
Balanitis
Eruptive xanthomata

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8
Q

Appearance of dermatitis herpetiformis

A

Chronic, recurrent, pruritic eruption on extensors extremities + trunk
Excoriated vesicles

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9
Q

If you have GI Sx with dermatitis herpetiformis, what disease might you associate it with?

A

Coeliac disease

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10
Q

Treatment dermatitis herpetiformis

A

Dapsone

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11
Q

Metabolic/endocrine DDx for generalised pruritis

A

Hyperthyroidism
Hypothyroidism
Chronic renal failure
Carcinoid

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12
Q

Malignant DDx for generalised pruritis

A

Lymphoma
Leukaemia
Myeloma
Solid cancer (rare)

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13
Q

Drugs that can caused generalised pruritis (4)

A

Aspirin
Alcohol
Morphine
Codeine

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14
Q

Haematological DDx for generalised pruritis (2)

A

IDA

Polycythaemia rubra vera

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15
Q

Hepatic DDx generalised pruritis

A

Obstructive biliary disease

Cholestasis of pregnancy

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16
Q

What is Xerosis?

A

Dry skin

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17
Q

Tests for widespread pruritis

A 
FBC (anaemia) 
U+E (uraemic syndrome) 
LFT (obstructive jaundice) 
Ferritin - IDA 
ESR - Non-specific marker lymphoma 
TFT - hyper/hypothyroidism
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18
Q

Where does Acanthosis nigricans tend to affect?

A

Axilla, groin, neck

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19
Q

Description of acanthosis nigricans

A

Velvety thickening hyperpigmentation, papillomatous skin

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20
Q

If benign, what conditions is acanthosis nigricans associated with?

A

Insulin Resistance + metabolic syndrome hence ACROMEGALY

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21
Q

If malignant, what cancer may acanthosis nigricans precede?

A

Gastric cancer

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22
Q

Which benign conditions is pyoderma gangrenosum associated with

A

UC, Chrons, Inflammatory arthritis, diverticulitis, chronic active hepatitis and Behcet’s

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23
Q

If What % of cases is pyoderma gangrenosum associated with malignancy?

A

> 10%

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24
Q

Which malignancies is pyoderma gangrenosum associated with?

A

Leukaemia, paraproteinemia, myeloma

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25
Q

Common sites pyoderma gangrenosum

A

Legs/CALF
Buttocks
Abdomen
Face

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26
Q

How does pyoderma gangrenosum start?

A

A tender nodule that ulcerates

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27
Q

Does enlargement of pyoderma gangrenosum happen slowly or rapidly?

A

Rapidly

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28
Q

Treatment pyoderma gangrenosum

A

Ciclopsorin

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29
Q

Appearance of acquired ichthyosis

A

Dry skin with ‘fish scale’

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30
Q

What medication can acquired ichthyosis be associated with?

A

Allopurinol

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31
Q

What malignant disease is acquired ichthyosis assoicated with?

A

Hodgkins

32
Q

Modal onset dermatomyositis associated with?

A

50-70y/o

33
Q

Causes of dermatomyositis?

A

Genetics
Autoimmune
Drugs

34
Q

Which cancers has dermatomyositis been linked to increased likelihood of developing? (6)

A 
Cervix
Lungs
Pancreas
Breast
Ovaries 
GIT
35
Q

Appearance of dermatomyositis at sun exposed areas?

A

Reddish/blue-purple patches

36
Q

Appearance of dermatomyositis on cheeks, nose, soulders, upper chest, elbows

A

Violaceous rash

37
Q

Appearance of dermatomyositis on eyelids

A

Helitrope (purple) rash

38
Q

Appearance of dermatomyositis on bony prominences (esp knuckles)

A

Gottron (purple) papules

39
Q

Tx regime for dermatomyositis?

A

Most will req Tx throughout their lifetime

40
Q

What is erythema noduosum

A

Immunological/inflammatory reaction pattern of SCT fat

41
Q

Appearance of erythema nodosum

A

Tender, erythematous, bruise like nodules on lower leg extensors

42
Q

Associated Sx erythema nodosum

A

Fever
Malaise
Arthralgia

43
Q

Who gets erythema nodosum

A

15-30y/o

F:M 3:1

44
Q

Underlying triggers erythma nodosum

A

Infection - strep, 1’TBB
Dx - sulphonamides, PO contraceptives
Systemic disease - sarcoid, Behcet’s, IBD/UC
Idiopathic

45
Q

What is erythema multiforme

A

Reaction pattern to blood vessels

46
Q

Appearance erythema multiforme

A

Red target lesions

Sometimes macular, often elevated w/ vesicle/bulla centrally

47
Q

Where does erythema multiforme affect ?

A

Extensor skin

48
Q

Associated Sx erythema multiforme

A

Pruritis

May be Fever, weakness, malaise

49
Q

How long will erythema multiforme take to settle?

A

A few weeks

50
Q

What is an intrinsic action of a drug on skin?

A

Predictable and dose related

51
Q

What is an idiosyncratic drug interaction on skin?

A

Fixed drug eruption

52
Q

Examples of non-specific drug eruptions

A

Urticaria + angiodema
Vasculitis
Erythema multiforme

53
Q

What is the most serious form of a non-specific drug eruption?

A

TEN

54
Q

Drugs that cause rashes (8)

A 
Penicilins/sulphonamides
Anticonvulsants
NSAIDs 
Thiazide diuretics
Allopurinol 
Gold + penicillamine
55
Q

How long after taking the drug do these rashes tend to occur?

A

8-21days after

56
Q

When does toxic erythema occur?

A

7-10 days after intro of drug

57
Q

Sx toxic erythema?

A

Fever
Malaise
Pruritis

58
Q

What are the 3 forms of toxic erythema?

A

Morbiliform
Scantiform
Confluent

59
Q

Appearance toxic erythema morbiliform

A

Symmetrical erythematous macules and papules

60
Q

Appearance of scantiform toxic erythema

A

Tiny red papules

61
Q

Appearance toxic erythema confluent

A

Large erythematous patches/urticated plaques

62
Q

What can toxic erythema progress into?

A

TEN

Erythroderma

63
Q

Tx toxic erythema

A

Stop drug

64
Q

What type of HS reaction is SJS?

A

IV

65
Q

Where does SJS affect?

A

Skin and mucous membranes

66
Q

How is SJS classified?

A

According to its body SA

67
Q

Def of SJS

A

<10% BSA

68
Q

Def overlapping SJS/TEN

A

10-30% BSA

69
Q

Def TEN

A

> 30% BSA

70
Q

Prodrome of SJS

A

Fever + resp Sx

71
Q

PS SJS

A 
Red macules 
Central blister formation 
Epidermal necrosis 
Extensive oral involvement 
Involves 2 mucosa sites 
Severe eye involvement
72
Q

Causes SJ S

A

Mycoplasma, HSV
Dx - NSAIDs, sulphonamides, penicillin’s, anticonvulsants, allopurinol
Idiopathic

73
Q

Mortality TEN

A

Up to 90%

74
Q

When does TEN present?

A

7-21 days after initiation of drug eruptions

75
Q

Appearance TEN

A

Tenderness + erythema, mucosal involvement. Erythematous macular rash with necrosis

76
Q

Mx TEN

A 
Stop Dx 
Supportive care @burns/ITU 
Fl
Temp control 
Sterile 
Wound care

CP2 - DERMATOLGY (7 decks)

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